Human Trafficking: Educating New Jersey Registered Nurses in Identifying Victims to Promote Positive Patient Outcomes

Monday, 18 November 2019: 9:20 AM

Jeanann S. Coppola, DNP, RN, CNM, CNE
E. Renee Cantwell, DNP, RN, CNE, CPHQ
School of Nursing, Rutgers University-Camden, Camden, NJ, USA

Human Trafficking (HT) victims are modern day slaves. Human trafficking is a global, national, and local public health issue with many quantifying concerns, including the identification and care of these individuals. Healthcare providers may encounter victims of HT in a clinical setting yet not realize that these individuals are being trafficked. Victims of trafficking may be performing jobs or activities which they were coerced or deceived into and which they cannot leave. HT can also result in serious health issues for the victims. By learning to recognize and report victims of HT, nurses who work in the clinical setting are in a prime position for helping them.

In the United States, there are approximately 800,000 reported HT victims who are men or women, adults or children, foreign nationals or US citizens. It is estimated that approximately 50,000 individuals are trafficked into the country every year. However, the exact number of U.S. victims of HT is difficult to determine due to the element of secrecy involved in the crime. Seventy nine percent of the victims of the HT trade fall into the slavery category of sexually abused women of which 21% are underage children. Female victims are both women and girls who are taken from their environment, sometimes across borders. In the United States, approximately 400,000 victims are domestic minors. Some are well educated, while others have no formal education. The International Labour Organization (ILO) estimated that Human Trafficking earned US traffickers more than $150 billion annually.

According to Assistant New Jersey Attorney General Tracy M. Thompson, New Jersey is a “hub for human trafficking, because of the state’s accessibility to Interstate 95, and the proximity to major tourist destinations like Atlantic City and New York City makes us more vulnerable and susceptible”. In New Jersey, the number of reported victims of HT has steadily increased since 2008. In 2016, 143 cases of HT were reported and in 2017, there were 417 calls to the hotline with 161 cases reported. These figures do not represent the numbers of unreported cases statewide. The New Jersey Attorney General’s office offers that HT in New Jersey has several apparent factors that make this area fertile grounds for this crime. Large cities with a larger homeless population, such as Camden City, have “a higher concentration of strip clubs and go-go bars than any other state in the country and the presence of gangs and organized crime all contribute to human trafficking”. The New Jersey Department of Justice data indicate that from September 2005 to 2014, there have been over 193 reported cases of trafficking and as of 2017, New Jersey is ranked 14th out of 50 states in numbers of victims. The National Runaway Safeline identifies that youth are very vulnerable and between “1.3 and 2.8 million runaways and homeless youth in the US are living on the streets each year, and one in three are lured by traffickers and pimps within 48 hours of leaving home”.

Large venue events, such as the Super Bowl in Rutherford NJ in 2016, and the National Football League draft in Philadelphia in 2017 were prime grounds for human trafficking operations. “A new study released by the University of Pennsylvania reveals startling statistics that show that the city’s homeless youth population could be the most vulnerable” during these types of events. They found that “1 in 5 of the youth were victims of sex trafficking; 14% exchanged sex to pay for basic needs; 95% had a history of child abuse, with nearly 50% reporting sex abuse; 58% of those trafficked did not have a caring adult in their lives; 67% percent of those trafficked did not graduate from high school”.

The American Academy of Pediatrics (2017) suggested that all individual healthcare professionals can prevent trafficking, recognize victims and intervene appropriately. They support a number of recommendations including “global efforts to address the social determinants of health, which are intimately connected to push and pull factors for human trafficking; and advocate for training of health care professionals”. The Emergency Nurses Association Position Statement on Human Trafficking Awareness posits that nurses “play a vital role in recognizing and responding to the needs of victims…. (and that) capturing these lifesaving opportunities requires proactive measures aimed at education awareness and training”. The New Jersey Hospital Association (2017) also recommend that starting in 2016, all healthcare professionals working closely with patients must complete an online Human Trafficking training course in identifying and assessing victims of HT.

In order to assess the awareness and knowledge of New Jersey nurses in relation to HT victims, in the Fall of 2017, an IRB approved 32-question survey was distributed through email targeting all registered nurses working in the state of New Jersey. Approximately 120,000 Registered Nurses (RN) names and email contact information were obtained from the New Jersey Nurses Association (NJNA). Of the emails sent, 2400 emails returned as undeliverable for various reasons. A total of 117,600 emails were successfully delivered with 734 individual RNs responding (0.6%).

Approximately 22,000 individual data entries were received and analyzed. The survey results indicated that RNs are deficient in HT information and want to learn. Currently, there is no formal HT education available specifically directed toward the RN population in NJ. The online education that is required by the New Jersey Hospital Association is written for “all healthcare workers and volunteers”, but not directed toward RNs, who have specific skills in patient assessment. The goals of this study were to determine RN knowledge of this public health issue, how to both identify and manage the victims, but also to increase awareness and identification of victims of HT in NJ. Based on the survey results, an educational initiative was developed and findings from the study and results from the educational initiative will be shared. The overall goal is to increase public awareness and moderate the incidence of victimization for positive patient outcomes.

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